Depression-Shwenk Flashcards

1
Q

T or F

You can feel sad without being depressed and depressed without feeling sad

A

T

It is a disease with impaired function of day to day activities

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2
Q

Depression is an indepenent risk factor for (blank)

A

poor prognosis (due to poor adherence, biological impairment, have high levels of morbidity and mortality, reduced function, meds have SEs)

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3
Q

T or F

Depression patients have feelings of inadequacy causing guilt

A

T, though they shouldnt since it is truly a disease

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4
Q

Depression involves (single/multiple) organ system

A

multiple

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5
Q

What shoud you ask immediately with a depressed individual?

A

hows your sleep?

look into emotion and cognition

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6
Q

What are co-morbid medical conditions associated with depression?

A

CHF, DM, HTN, CAD

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7
Q

ANy chronic pain diseases or a difficult patient should trigger your mind to think what?

A

that your patient is depressed

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8
Q
What is this:
Verbally unproductive
Flat, “energy sump”
“Problem” patient
Multiple complaints, systems, visits
Symptom-sign mismatch
Physician dysphoria when with patient
A

depressed patient

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9
Q

(blank) of all visits for depression in primary care
(blank)% of visits for antidepressants to primary care
More than (blank) of antidepressants prescribed by primary care physicians
More than half of antidepressants prescribed for reasons other than (blank)

A

Third
41%
half
depression

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10
Q

What are indications for referral?

A
Severe suicidal thinking
Psychosis, bipolar disorder, Axis II
Complicated substance abuse
Poor psychosocial support
Disorganized, rapid deterioration
Failed treatment
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11
Q

Where should you always start with depression?

A

DISPEL MYTHS

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12
Q

What are the 10 rules for caring for depressed patients?

A
  1. Dispel myths
  2. Use epidemiology
  3. Indirect markers and clues
  4. Focus on functional impairment
  5. Counter competing priorities (make sure depression is prioritized)
  6. Co-morbidity
  7. Psychopharmacology
  8. Education and supportive counseling
  9. Treat as a chronic disease
  10. Psychiatric consultation
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13
Q

T or F
Physician educational interventions show little effect
Barriers to improvement more systemic than professional

A

T

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14
Q

What medical student are the most depressed?

A

2nd year female medical students who are unmarried or have children
(medical students are more likely to commit suicide then age matched peers)

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15
Q

Why do you think physicians commit suicide more than other occupations?

A

Avoid seeking care due to privacy concerns/stigma
Prescribe own antidepressant (30% vs. 9.9%)
Seek care outside community and/or pay cash for care
Not seek care due to concern about medical staff privileges or licensing

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16
Q

What are the Factors Affecting Medical Students with Depression?

A
  • Med students see depression as personal weakness
  • There is social/professional discrimination
  • Devaluation of depressed students (think they are not worthy of good school performance)
  • Perceptions of poor performance by depressed medical students
  • Need for secrecy